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Oct-20-2009 04:21pm From-CITY OF ORONO +9522494616 T-862 P.003/003 F-144 <br /> , <br /> { y � �I'hlh�i�.,�d'f : . i �;�i„ �'���� �t <br /> `����� � rI. � �qN;��,i ,i "�I, ' � 7I „i� � � {� i ?+ ��� �� " � i �II! � +�� ; i <br /> ' +i;� (�I��I��I 11 rE� � I'� �����'A I !�I ,� 2 ��it�,, ��iil i�. 11� 1 . f �P r1 IP i�r(:��I ��I��'i�{� � i }I f I��I�ii h�i� � 'r;I: <br /> � � II �� I � f I �1� 1!' �ry i�� �� � t� �i �i1�'I� ��f��1��j� I�1�� �'�1�� ��� ���I f���4i <br /> �I i��i���i�+ �t���!' a d �N ,��I i I 1� � U p+� �� I I ' <br /> �d l�•��il � t"�fiti II r..1��i i.i���.�,�'��' �� �. ���A�"i�T��� �i�� ��' � ��.��,i d��6�I11��!I�A���u i?i���.li i�I'p<l�1«I J��I�,�!i.i{I'� <br /> Q Yes,this secrion applics <br /> '�he rcplacemenc of a Reside tial fixturc or appliance that meets all tlu�ee of the followin�requiremems� <br /> 1. Docs not requue modificatian to�lec�ical or gas service. <br /> 2. Has a t�tal cosz of$�00.00 or less;excl 'n the cost of the fixtura or ap}�liancc_and <br /> 3. Is improved,instalted or rE�placcd by rhe homeowner or licensed contracrc�r. <br /> Skip nzxt section,if this appiics; Cost of permit $ 15.00 <br /> State Surcharge � .50 <br /> Mail-In Fce(If Applicable) $ 2.00 <br /> Total permit�ee $ <br /> !� � ! 1, iF �r ��'I�tfi �I�� � ,s1�r s .��. H ''•��Ni���;:��t��s��'i,l�i;'����`rFi�IE�iin f'fi� <br /> If above does not apply;follow guidelines below: <br /> 1. CONTRAC:T_PRICE *is 1.25%of conrract price with a(Minimum�'cc of�50.00) <br /> 35a� X_o�z5� •c�� <br /> (connac�price) (��iinimum�SU.t�) <br /> 2. STATF STTRCHARGE "'"Add the Seare Bldg Code 17iv. Surcharge(Minimum�'ee of 3.50) <br /> x.0005 $ <br /> (ConirACt priCd) {minimum$ .SO) <br /> 3. P�STAG�&HANDLING(Only on Mail-In Applications) $_. 2_00 <br /> 4. TOTAL P�RMIT FE�:(Add T�ines 1-3 Above) $„�v�� <br /> ■ w CONTRACT PRICE or JOB COST means the setu$1 or esrimated dollar am��unt chaxged for the <br /> permitted work including materials,lAbor,profit, and othzr fixed costs, Tt is the anwunt to be cl�arged <br /> to the customer for the work done, If any maierial, equipment, labor or installat�ons are furnishecl by <br /> rhe owner, tenant or any otlier party, the reasonablz markec value of such items rnust be added to the <br /> escimatcd cost or conirace price for permit fee puiposes. in the event that ther: is a dispuie on ihe <br /> Amount of the job cost, the City n�ay raqucst che submission of a signed eopy of'thc actual contract. <br /> ■ **The STATE SURCHARG�is.0�0� of rhe Building Departmzn[at(952)249-4600 for tlie pricr. <br /> � i h i ,•� �� Ii� f y(� i � .,�. �• �� �{� I' i: 'r � h ' ��. �,� � �p� <br /> �1`����i Ir'��al�,.� ���E��. . fl��I � ��h.i 1 �r ' � �M�-��..�i I .I , I. i F��'��EV�����..��'�I 1.1��II:���f`���I I(I:t <br /> The undersigned hereby applies to the City for issuance of a Mechanical Pernlit, agrees to do all <br /> work in strict accordance with the ordinanc�s of the Ciry and the regulatiuns of the State of <br /> Minnesota, and certifies that all statements inade on this application are �;omplete, true and <br /> correct. <br /> Applicant's SignatGtre: ►tdl.i/�/�� Date: ����"��� <br /> 3 <br />